Introducing Hot Shots, a series that examines how Ozempic and other GLP-1 drugs have transformed the way we think about our bodies, weight loss, and wellness.
The first time Heather’s doctor suggested she try Ozempic, she was less than enthusiastic. “I thought, ‘I’m not that sick,’” says the 41-year-old Florida behavioral analyst. “Giving myself a weekly injection sounded so serious.” Less than two years later, she’s more than 35 pounds lighter and no longer prediabetic. Friends and family are supportive—and also a little jealous. People often ask her, “How did you get it? How did you qualify?” Heather says. “I guess they think I somehow cheated the system.”
Despite huge demand for the diabetes treatment-turned-weight-loss wonder drug, getting a prescription for Ozempic has been harder than scoring Eras Tour tickets. As word spread about its success rate, celebs and the rich and well-connected started using it, fueling a supply shortage that has lasted for years. Drugmakers have been racing to develop new and needle-free alternatives, with a plethora of pill versions now being tested in clinical trials. Early results suggest that the formulas may help people drop even more weight—and could help biotech and pharmaceutical companies make a killing in a market that’s predicted to be worth $200 billion by 2031.
In one study, Ozempic users lost almost 6 percent of their body weight after three months. According to preliminary data from Phase 1 trials, a new pill by the makers of Ozempic can reduce body weight by more than double (10 to 13 percent) in the same time frame. Recent data published from a Phase 2 trial showed that a once-daily pill from Eli Lilly called orforglipron helped patients lose up to nearly 15 percent of their body weight after eight months.
In addition to being a convenient alternative for those squeamish about needles, pill options could make it less likely that Hollywood could hoard it all for itself. “Manufacturing pills is generally cheaper and easier than producing injectables, so it should help solve the shortages we see today,” says Daniel Drucker, MD, an endocrinologist and professor at the University of Toronto. A month’s supply of Ozempic, Mounjaro, and other brands can tally around $1,000 without insurance. The pills have the potential to offer the same (or better) benefits for under $100, which would make them more accessible. Ozempic is inspiring a new entry in dupe culture.
FDA approval may still be a few years away, but Wall Street and obesity experts are excited nonetheless and predict that the impacts could be staggering. Over 40 percent of American adults are now considered obese, and, according to data from 2021, nearly 15 percent of adults are diabetic and around 98 million are prediabetic. If access to these new drugs could be expanded, over 42,000 deaths could be prevented every year, according to a study in the Proceedings of the National Academy of Sciences. It could also upend the entire food and diet industry, transform the economy by lowering health care costs and increasing productivity, and forever alter the way we think about weight.
Contrary to ideas that diet culture has embedded in our collective subconscious, Ozempic and the expanding class of drugs known as GLP-1 receptor agonists (or GLP-1s) offer further evidence that obesity is a chronic condition driven in part by genetics, biology, and environment—not solely willpower or lifestyle choices. In a healthy body, the brain receives signals when it’s full. As weight increases, these communication pathways get damaged. Ozempic addresses the dysregulation by mimicking a natural hormone in the body that helps control blood sugar and appetite called glucagon-like peptide 1, or GLP-1. Along with numbers on the scale, risks for diabetes, kidney and heart diseases, fatty liver disorders, and cancer all appear to go down. Some GLP-1 users also report fewer cravings for unhealthy junk foods and even alcohol, and the new medications may hold promise as treatments for addiction and substance abuse. The drugs in development now are dual agonists (like Mounjaro) and triple agonists, which activate multiple receptors simultaneously to enhance their ability to promote weight loss.
There are side effects with GLP-1s, which could also be present in the new class of drugs, although drugmakers are hoping they could be less intense. (The most common side effects of GLP-1s are gastrointestinal.) “We should always keep evaluating their safety, but we have a good understanding of what this class of medicine does, and it has a pretty favorable risk-benefit ratio,” Drucker says.
As the new drugs roll out, some detractors could continue to argue that GLP-1 drugs are just a Band-Aid, pointing out that many people gain the weight back as soon as they get off the meds. Robert F. Kennedy Jr., who was tapped to lead the Department of Health and Human Services for the Trump administration, recently suggested that investments in weight-loss drugs would be better spent simply delivering three healthy meals to people every day.
Still, the diet and wellness industry is pivoting in anticipation of the new pills, and some supplement brands are selling plant-based GLP-1 substitutes via tinctures and gummies. There is hope that new drugs and a better understanding of obesity will help reduce stigma and fat-shaming, just as awareness of mental health helped break the taboo around antidepressants. “It’s not just a lifestyle choice; it really is a biological disease that we actually don’t fully understand,” says Janice Jin Hwang, MD, an endocrinologist at UNC School of Medicine. “The fact that we know these medicines work in the brain and the pancreas and they’re so effective is proof that it’s a biological mechanism that’s out of whack.”
Research consistently shows that social inequities and environment are key factors behind obesity disparities. If these new drugs live up to the hype, we may finally have a weight-loss tool that’s not accessible only to those with the budget and privilege to plan their days around Erewhon, private trainers, and customized detox plans. For some, they can also offer much-needed validation after years of being told they simply weren’t trying hard enough. “I was so frustrated before—tracking my food and exercise with nothing to show for it,” Heather says. “Turns out, my body just needed a little extra help.”
A version of this story appears in the February 2025 issue of ELLE.
